NPIMap

Organization Active NPI

Iowa Specialty Hospital- Clarion

Doing business as Clarion Clinic

  • Rural Health Clinic/Center
  • Clarion, IA
National Provider Identifier
1396792008
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
990177H Issued in IA
Legal business name
IOWA SPECIALTY HOSPITAL- CLARION
Doing business as
Clarion Clinic
Practice address
215 13TH Ave SW
Clarion, IA 50525-2078
Phone
(515) 532-2836
Fax
(515) 532-2523
NPI assigned
May 28, 2006
Last updated
Dec 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steve Simonin
Title
Ceo
Phone
(515) 532-9333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 990177H IA Primary

Addresses

Primary practice location

215 13TH Ave SW
Clarion, IA 50525-2078

Mailing address

215 13TH Ave SW
Clarion, IA 50525-2078
Phone (515) 532-2836

Other names 1

  • Clarion Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030103000013 IA Part A Provider - Rural Health Clinic 3375451347 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clarion, IA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396792008. Details of each certification follow.

Rural health clinic certification: CCN 163495

Legal name
IOWA SPECIALTY HOSPITAL- CLARION
Doing business as
CLARION CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 2003
Last certification
Jun 1, 2022
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
215 13TH Ave SW
Clarion, IA 50525-2078
Related CCNs
161302

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ia Specialty Hosp - Clarion22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

319 3rd Ave NE
Clarion, IA 50525
Phone (888) 258-0078

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gregory C Polzin Individual Corporate Director Jul 22, 2013
Sherri Obrien Individual Corporate Director Jun 29, 2021
Katrina Stecher Individual Corporate Director Oct 11, 2017
Judith a Ritter Individual Corporate Director Oct 11, 2017
Missy Brannick Individual W-2 Managing Employee Oct 11, 2017
Sue Martin Individual Corporate Director Oct 11, 2017
Steven J Simonin Individual Corporate Officer Jul 22, 2013
Anthony Meinke Individual Corporate Director Oct 29, 2019
Kelly J Leu Individual W-2 Managing Employee Oct 11, 2017

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1396792008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 13TH AVE SW",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252078",
            "telephone_number": "515-532-2836",
            "fax_number": "515-532-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 13TH AVE SW",
            "city": "CLARION",
            "state": "IA",
            "postal_code": "505252078",
            "telephone_number": "515-532-2836",
            "fax_number": "515-532-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOWA SPECIALTY HOSPITAL- CLARION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "SIMONIN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-532-9333"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IA",
            "license": "990177H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarion Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarion Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarion, IA

Sources for this page

Verify at the official NPI Registry.